Vaccine Survey

Has your baby been vaccinated?

• No‚ my baby will not get vaccinated.
• My baby has not received any injections‚ but I plan to take her.
• My baby has had some injections‚ and we plan to get them all.
• Yes‚ my baby is fully vaccinated.

I am the baby's

• Mother
• Father
• Sibling
• Caretaker
• Other